How do I pick an Insurance Plan?
It’s that time of year again! No I’m not referring to pumpkins, leaves changing color, cool weather or football. It’s time to renew or change your health insurance plan. Now that you have become a patient of ours or soon plan to be and are taking advantage of all that Direct Primary Care offers it can make choosing your new plan from the state, government, employer or direct from the vendor more confusing than before. There are often many choices, with slight differences that are difficult to decipher. Beyond that, because price transparency is such an issue in healthcare, it is often hard to plan or budget for future costs when there is no way to find out how much these services actually cost! Below, I’ve tried to outline a couple tips while going through this process. (Of course if you would like to sit down with us and go over this we would be happy to oblige)
1)Nothing is free!!: Many patients get a large portion of their health insurance paid for by a third party (employer, government, etc). This creates the notion that health care is cheap or free in certain situations. Please remember that although you may not pay much in monthly premiums or out of pocket costs for your insurance, your employer is likely paying an for health care services you may not even use.
2)Know your family: Unfortunately, because this can be so complicated, many patients simply select the most inclusive insurance options, which are also the most expensive. Sit down and review what medical services you and your family have used over the past few years. What medications do you require monthly, if any? Do you see specialists, and why? Do you know of any bigger health expenses that may come up next year (like planning for a child or an elective surgery?) If you feel that what you will need most is just your primary care which would be covered within your subscription to our practice it allows you to avoid the so called “Cadillac” plans and be more frugal in the selection of your plan.
3)Premiums and Deductibles: Just to review, a premium is the amount that you (or a third party) pay monthly for the privilege of being insured. The deductible is the total amount of out of pocket costs you and your family can incur during the year on top of the monthly premium you already pay. The lower your monthly premiums, the higher your out of pocket costs may be. For instance, for a young family of 4 buying insurance from BCBS, the monthly premium for a $2,000 deductible plan is about $500 more a month than the $10,000 deductible plan… that’s $6,000 extra in monthly premiums over the course of the year! When most of our patients do the math they often will raise their deductible to save on their monthly premiums knowing that a good majority of their care will be covered by their subscription to our practice. Leaving their insurance to just cover major issues or catastrophes.”
Even the $2000 deductible plan listed above leaves a family paying out of pocket for much of their costs in a year. Those costs are often inflated because of insurance and the amount is completely unknown to the patient prior to utilizing the service (try to think of another purchase you make where you do not know the cost prior to buying?!?)
So, if you have a relatively healthy family, ask yourself why you (or your employer) pay so much more in premiums for, what should be, cheap and comprehensive primary care services. And wouldn’t you want an affordable, budgetable, transparent monthly fee that will cover most everything that will come up during a given year including keeping you out of the urgent care and emergency room (both costly services)?
If you do have some chronic medical concerns, think about the specialists you are seeing and the medications you are on. Are your current doctors taking your finances into consideration or prescribing and ordering expensive medications/tests without thinking about it? Do they use technology to help track health outcomes in real time, expedite changes in treatment plans and save you trips to the office, like Twine? If not, it’s probably worth making an appointment here at Direct Doctors so we can discuss how our practice may work with your medical and insurance needs. The best part is, the consultation is free!
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Lauren Hedde, DO; James Hedde, DO and Mark Turshen, MD are Family Physicians and Co- Founders of Direct Doctors, Inc. a Direct Primary Care Practice.